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Behluli E, Preuer HM, Schiefermeier-Mach N, Hornung R, Küchler M, Prokopetz M. Patient-centric comparative analysis of experiences in open upright and conventional closed MRI scanners. Radiography (Lond) 2024; 30:1258-1264. [PMID: 38991328 DOI: 10.1016/j.radi.2024.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/23/2024] [Accepted: 06/26/2024] [Indexed: 07/13/2024]
Abstract
INTRODUCTION MRI often induces anxiety, leading to incomplete scans and claustrophobia-related distress. Open MRI systems aim to enhance patient comfort. This study examines how prior MRI experiences impact subsequent encounters in an open upright MRI scanner. METHODS In this cross-sectional study, 118 adult patients completed a self-administered questionnaire from August 2022 to October 2023. It covered previous MRI experiences, including questions about claustrophobia, premature scan terminations, sedative medication usage, general MRI experiences, and interactions with radiology technologists. RESULTS Patients in open upright MRI reported less claustrophobia compared to closed MRI systems (18.4% vs. 58.3%), fewer premature scan terminations (5.3% vs. 31.0%), and less sedative use (5.3% vs. 46.9%). Moderate positive correlations were found between past and current claustrophobic events and premature scan terminations. Effective communication with radiology technologists was essential for patient comfort and reduced claustrophobia. Scan duration and noise triggered discomfort in 26.1% and 21.6% of study participants respectively. Persons without prior MRI experience were more satisfied with the examination and expressed no clear preference for future MRI settings, contrasting those with previous exposure favoring the open MRI setup. CONCLUSION The study emphasizes the benefits of open upright MRI for high-risk claustrophobic patients. It identifies the lasting impact of negative MRI experience on future examinations and highlights the crucial role of radiology technologists. IMPLICATIONS FOR PRACTICE Integrating open MRI scanners in medical facilities and prioritizing effective communication with radiology technologists enhances patient comfort. Positive experiences with open MRI may improve patient compliance and offer greater flexibility for future examinations.
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Affiliation(s)
- E Behluli
- Department of Radiological Technologies, Health University of Applied Sciences Tyrol/ Fhg - Zentrum für Gesundheitsberufe Tirol, Innsbruck, Austria; Radiological Institute Zurich-Altstetten, Zurich, Switzerland
| | - H M Preuer
- Department of Radiological Technologies, Health University of Applied Sciences Tyrol/ Fhg - Zentrum für Gesundheitsberufe Tirol, Innsbruck, Austria
| | - N Schiefermeier-Mach
- Unit for Research and Innovation, Health University of Applied Sciences Tyrol/ Fhg - Zentrum für Gesundheitsberufe Tirol, Innsbruck, Austria
| | - R Hornung
- Radiological Institute Zurich-Altstetten, Zurich, Switzerland
| | - M Küchler
- Radiological Institute Zurich-Altstetten, Zurich, Switzerland
| | - M Prokopetz
- Department of Radiological Technologies, Health University of Applied Sciences Tyrol/ Fhg - Zentrum für Gesundheitsberufe Tirol, Innsbruck, Austria.
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Murali S, Ding H, Adedeji F, Qin C, Obungoloch J, Asllani I, Anazodo U, Ntusi NAB, Mammen R, Niendorf T, Adeleke S. Bringing MRI to low- and middle-income countries: Directions, challenges and potential solutions. NMR IN BIOMEDICINE 2024; 37:e4992. [PMID: 37401341 DOI: 10.1002/nbm.4992] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 07/05/2023]
Abstract
The global disparity of magnetic resonance imaging (MRI) is a major challenge, with many low- and middle-income countries (LMICs) experiencing limited access to MRI. The reasons for limited access are technological, economic and social. With the advancement of MRI technology, we explore why these challenges still prevail, highlighting the importance of MRI as the epidemiology of disease changes in LMICs. In this paper, we establish a framework to develop MRI with these challenges in mind and discuss the different aspects of MRI development, including maximising image quality using cost-effective components, integrating local technology and infrastructure and implementing sustainable practices. We also highlight the current solutions-including teleradiology, artificial intelligence and doctor and patient education strategies-and how these might be further improved to achieve greater access to MRI.
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Affiliation(s)
- Sanjana Murali
- School of Medicine, Faculty of Medicine, Imperial College London, London, UK
| | - Hao Ding
- School of Medicine, Faculty of Medicine, Imperial College London, London, UK
| | - Fope Adedeji
- School of Medicine, Faculty of Medicine, University College London, London, UK
| | - Cathy Qin
- Department of Imaging, Imperial College Healthcare NHS Trust, London, UK
| | - Johnes Obungoloch
- Department of Biomedical Engineering, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Iris Asllani
- Department of Biomedical Engineering, Rochester Institute of Technology, Rochester, New York, USA
| | - Udunna Anazodo
- Department of Medical Biophysics, Western University, London, Ontario, Canada
- The Research Institute of London Health Sciences Centre and St. Joseph's Health Care, London, Ontario, Canada
| | - Ntobeko A B Ntusi
- Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
- South African Medical Research Council Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, Cape Town, South Africa
| | - Regina Mammen
- Department of Cardiology, The Essex Cardiothoracic Centre, Basildon, UK
| | - Thoralf Niendorf
- Berlin Ultrahigh Field Facility (BUFF), Max-Delbrück Centre for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Sola Adeleke
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
- High Dimensional Neuro-oncology, University College London Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK
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Oerther B, Engel H, Nedelcu A, Strecker R, Benkert T, Nickel D, Weiland E, Mayrhofer T, Bamberg F, Benndorf M, Weiß J, Wilpert C. Performance of an ultra-fast deep-learning accelerated MRI screening protocol for prostate cancer compared to a standard multiparametric protocol. Eur Radiol 2024:10.1007/s00330-024-10776-7. [PMID: 38780766 DOI: 10.1007/s00330-024-10776-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/23/2024] [Accepted: 03/30/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES To establish and evaluate an ultra-fast MRI screening protocol for prostate cancer (PCa) in comparison to the standard multiparametric (mp) protocol, reducing scan time and maintaining adequate diagnostic performance. MATERIALS AND METHODS This prospective single-center study included consecutive biopsy-naïve patients with suspected PCa between December 2022 and March 2023. A PI-RADSv2.1 conform mpMRI protocol was acquired in a 3 T scanner (scan time: 25 min 45 sec). In addition, two deep-learning (DL) accelerated sequences (T2- and diffusion-weighted) were acquired, serving as a screening protocol (scan time: 3 min 28 sec). Two readers evaluated image quality and the probability of PCa regarding PI-RADSv2.1 scores in two sessions. The diagnostic performance of the screening protocol with mpMRI serving as the reference standard was derived. Inter- and intra-reader agreements were evaluated using weighted kappa statistics. RESULTS We included 77 patients with 97 lesions (mean age: 66 years; SD: 7.7). Diagnostic performance of the screening protocol was excellent with a sensitivity and specificity of 100%/100% and 89%/98% (cut-off ≥ PI-RADS 4) for reader 1 (R1) and reader 2 (R2), respectively. Mean image quality was 3.96 (R1) and 4.35 (R2) for the standard protocol vs. 4.74 and 4.57 for the screening protocol (p < 0.05). Inter-reader agreement was moderate (κ: 0.55) for the screening protocol and substantial (κ: 0.61) for the multiparametric protocol. CONCLUSION The ultra-fast screening protocol showed similar diagnostic performance and better imaging quality compared to the mpMRI in under 15% of scan time, improving efficacy and enabling the implementation of screening protocols in clinical routine. CLINICAL RELEVANCE STATEMENT The ultra-fast protocol enables examinations without contrast administration, drastically reducing scan time to 3.5 min with similar diagnostic performance and better imaging quality. This facilitates patient-friendly, efficient examinations and addresses the conflict of increasing demand for examinations at currently exhausted capacities. KEY POINTS Time-consuming MRI protocols are in conflict with an expected increase in examinations required for prostate cancer screening. An ultra-fast MRI protocol shows similar performance and better image quality compared to the standard protocol. Deep-learning acceleration facilitates efficient and patient-friendly examinations, thus improving prostate cancer screening capacity.
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Affiliation(s)
- B Oerther
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.
| | - H Engel
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - A Nedelcu
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - R Strecker
- MR Application Predevelopment, Siemens Healthineers GmbH, Erlangen, Germany
- EMEA Scientific Partnerships, Siemens Healthineers GmbH, Erlangen, Germany
| | - T Benkert
- MR Application Predevelopment, Siemens Healthineers GmbH, Erlangen, Germany
| | - D Nickel
- MR Application Predevelopment, Siemens Healthineers GmbH, Erlangen, Germany
| | - E Weiland
- MR Application Predevelopment, Siemens Healthineers GmbH, Erlangen, Germany
| | - T Mayrhofer
- School of Business Studies, Stralsund University of Applied Sciences, Stralsund, Germany
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - F Bamberg
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - M Benndorf
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - J Weiß
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - C Wilpert
- Department of Radiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
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Nohava L, Czerny R, Tik M, Wurzer D, Laistler E, Frass-Kriegl R. Citizen science approach to assessing patient perception of MRI with flexible radiofrequency coils. Sci Rep 2024; 14:2811. [PMID: 38307928 PMCID: PMC10837436 DOI: 10.1038/s41598-024-53364-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 01/30/2024] [Indexed: 02/04/2024] Open
Abstract
Magnetic Resonance Imaging (MRI) is a major medical imaging modality, which is non-invasive and provides unique soft tissue contrast without ionizing radiation. The successful completion of MRI exams critically depends on patient compliance, and, thus patient comfort. The design, appearance and usability of local MRI radiofrequency (RF) coils potentially influences the patients' perception of the exam. However, systematic investigations and empirical evidence for these aspects are missing. A questionnaire specifically evaluating the impact of RF coils on patient comfort in MRI would be a valuable addition to clinical studies comparing the performance of novel flexible RF coils with standard rigid coils. This paper describes the development of such a questionnaire in the scope of a citizen science (CS) initiative conducted with a group of students at the upper secondary school level. In this work, the CS initiative is presented in the format of a case report and its impact on scientific projects and the students' education is outlined. The resulting questionnaire is made available in German and English so as to be directly applicable by researchers working on the clinical evaluation of novel RF coils or the comfort evaluation of specific hardware setups in general.
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Affiliation(s)
- Lena Nohava
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Raphaela Czerny
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Martin Tik
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Dagmar Wurzer
- Bundes(real)gymnasium BG/BRG Keimgasse, Mödling, Austria
| | - Elmar Laistler
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Roberta Frass-Kriegl
- High Field MR Center, Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
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Madl JEM, Nieto Alvarez I, Amft O, Rohleder N, Becker L. The Psychological, Physiological, and Behavioral Responses of Patients to Magnetic Resonance Imaging (MRI): A Systematic Review and Meta-Analysis. J Magn Reson Imaging 2024; 59:675-687. [PMID: 37990634 DOI: 10.1002/jmri.29134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/27/2023] [Accepted: 10/28/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND MRI is generally well-tolerated although it may induce physiological stress responses and anxiety in patients. PURPOSE Investigate the psychological, physiological, and behavioral responses of patients to MRI, their evolution over time, and influencing factors. STUDY TYPE Systematic review with meta-analysis. POPULATION 181,371 adult patients from 44 studies undergoing clinical MRI. ASSESSMENT Pubmed, PsycInfo, Web of Science, and Scopus were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Quality appraisal was conducted with the Joanna Briggs Institute critical appraisal tools. Meta-analysis was conducted via Meta-Essentials workbooks when five studies were available for an outcome. Psychological and behavioral outcomes could be analyzed. Psychological outcomes were anxiety (State-Trait-Anxiety Inventory, STAI-S; 37) and willingness to undergo MRI again. Behavioral outcomes included unexpected behaviors: No shows, sedation, failed scans, and motion artifacts. Year of publication, sex, age, and positioning were examined as moderators. STATISTICAL TESTS Meta-analysis, Hedge's g. A P value <0.05 was considered to indicate statistical significance. RESULTS Of 12,755 initial studies, 104 studies were included in methodological review and 44 (181,371 patients) in meta-analysis. Anxiety did not significantly reduce from pre- to post-MRI (Hedge's g = -0.20, P = 0.051). Pooled values of STAI-S (37) were 44.93 (pre-MRI) and 40.36 (post-MRI). Of all patients, 3.9% reported unwillingness to undergo MRI again. Pooled prevalence of unexpected patient behavior was 11.4%; rates for singular behaviors were: Failed scans, 2.1%; no-shows, 11.5%; sedation, 3.3%; motion artifacts, 12.2%. Year of publication was not a significant moderator (all P > 0.169); that is, the patients' response was not improved in recent vs. older studies. Meta-analysis of physiological responses was not feasible since preconditions were not met for any outcome. DATA CONCLUSION Advancements of MRI technology alone may not be sufficient to eliminate anxiety in patients undergoing MRI and related unexpected behaviors. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY: Stage 5.
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Affiliation(s)
- Janika E M Madl
- Chair of Health Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Siemens Healthcare GmbH, Erlangen, Germany
| | - Isabel Nieto Alvarez
- Siemens Healthcare GmbH, Erlangen, Germany
- Chair of Digital Health, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Intelligent Embedded Systems Lab, University of Freiburg, Freiburg im Breisgau, Germany
| | - Oliver Amft
- Chair of Digital Health, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Intelligent Embedded Systems Lab, University of Freiburg, Freiburg im Breisgau, Germany
- Hahn-Schickard, Freiburg im Breisgau, Germany
| | - Nicolas Rohleder
- Chair of Health Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Linda Becker
- Chair of Health Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Humanwissenschaftliche Fakultät, Vinzenz Pallotti University, Vallendar, Germany
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Rusche T, Vosshenrich J, Winkel DJ, Donners R, Segeroth M, Bach M, Merkle EM, Breit HC. More Space, Less Noise-New-generation Low-Field Magnetic Resonance Imaging Systems Can Improve Patient Comfort: A Prospective 0.55T-1.5T-Scanner Comparison. J Clin Med 2022; 11:jcm11226705. [PMID: 36431182 PMCID: PMC9692643 DOI: 10.3390/jcm11226705] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The objectives of this study were to assess patient comfort when imaged on a newly introduced 0.55T low-field magnetic resonance (MR) scanner system with a wider bore opening compared to a conventional 1.5T MR scanner system. MATERIALS AND METHODS In this prospective study, fifty patients (mean age: 66.2 ± 17.0 years, 22 females, 28 males) underwent subsequent magnetic resonance imaging (MRI) examinations with matched imaging protocols at 0.55T (MAGNETOM FreeMax, Siemens Healthineers; Erlangen, Germany) and 1.5T (MAGNETOM Avanto Fit, Siemens Healthineers; Erlangen, Germany) on the same day. MRI performed between 05/2021 and 07/2021 was included for analysis. The 0.55T MRI system had a bore opening of 80 cm, while the bore diameter of the 1.5T scanner system was 60 cm. Four patient groups were defined by imaged body regions: (1) cranial or cervical spine MRI using a head/neck coil (n = 27), (2) lumbar or thoracic spine MRI using only the in-table spine coils (n = 10), (3) hip MRI using a large flex coil (n = 8) and (4) upper- or lower-extremity MRI using small flex coils (n = 5). Following the MRI examinations, patients evaluated (1) sense of space, (2) noise level, (3) comfort, (4) coil comfort and (5) overall examination impression on a 5-point Likert-scale (range: 1= "much worse" to 5 = "much better") using a questionnaire. Maximum noise levels of all performed imaging studies were measured in decibels (dB) by a sound level meter placed in the bore center. RESULTS Sense of space was perceived to be "better" or "much better" by 84% of patients for imaging examinations performed on the 0.55T MRI scanner system (mean score: 4.34 ± 0.75). Additionally, 84% of patients rated noise levels as "better" or "much better" when imaged on the low-field scanner system (mean score: 3.90 ± 0.61). Overall sensation during the imaging examination at 0.55T was rated as "better" or "much better" by 78% of patients (mean score: 3.96 ± 0.70). Quantitative assessment showed significantly reduced maximum noise levels for all 0.55T MRI studies, regardless of body region compared to 1.5T, i.e., brain MRI (83.8 ± 3.6 dB vs. 89.3 ± 5.4 dB; p = 0.04), spine MRI (83.7 ± 3.7 dB vs. 89.4 ± 2.6 dB; p = 0.004) and hip MRI (86.3 ± 5.0 dB vs. 89.1 ± 1.4 dB; p = 0.04). CONCLUSIONS Patients perceived 0.55T new-generation low-field MRI to be more comfortable than conventional 1.5T MRI, given its larger bore opening and reduced noise levels during image acquisition. Therefore, new concepts regarding bore design and noise level reduction of MR scanner systems may help to reduce patient anxiety and improve well-being when undergoing MR imaging.
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Ohliger MA. Invited Commentary: MRI Radiofrequency Coils-Current Uses and Future Innovation. Radiographics 2022; 42:E100-E101. [PMID: 35394889 DOI: 10.1148/rg.210214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Michael A Ohliger
- From the Department of Radiology and Biomedical Imaging, University of California, San Francisco, Box 0628, 1001 Potrero Ave, SFGH 5, Room 1x60, San Francisco, CA 94143
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Vazquez F, Marrufo O, Solis-Najera SE, Martin R, Rodriguez AO. External Waveguide Magnetic Resonance Imaging for lower limbs at 3 T. Med Phys 2021; 49:158-168. [PMID: 34633673 DOI: 10.1002/mp.15281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/01/2021] [Accepted: 09/21/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION We report a method based on the travelling-wave MRI approach, in order to acquire images of human lower limbs with an external waveguide at 3 T. METHOD We use a parallel-plate waveguide and an RF surface coil for reception, while a whole-body birdcage is used for transmission. The waveguide and the surface coil are located right outside the magnet, in the MR conditional devices zone. We ran numerical simulations to investigate the B1 field generated by the surface coil located at one of the waveguides, as well as a saline-solution phantom positioned on the opposite side (150 cm away) inside the magnet. RESULTS We obtained phantom images by varying the distance between the coil and the phantom, in order to investigate the signal-to-noise ratio and to validate our numerical simulations. Lower limb images of a healthy volunteer were also acquired, demonstrating the viability of this approach. Standard pulse sequences were used and no physical modifications were made to the MR imager. CONCLUSIONS These numerical and experimental results show that travelling-wave MRI can produce high-quality images with only a simple waveguide and an RF coil located outside the magnet. This can be particularly favorable when acquiring images of lower limbs requiring a larger field of view.
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Affiliation(s)
- F Vazquez
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - O Marrufo
- Department of Neuroimage, Instituto Nacional de Neurologia y Neurocirugia MVS, Mexico City, 14269, Mexico
| | - S E Solis-Najera
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - R Martin
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - A O Rodriguez
- Department of Electrical Engineering, Universidad Autonoma Metropolitama Iztapalapa, Mexico City, 09340, Mexico
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Oztek MA, Brunnquell CL, Hoff MN, Boulter DJ, Mossa-Basha M, Beauchamp LH, Haynor DL, Nguyen XV. Practical Considerations for Radiologists in Implementing a Patient-friendly MRI Experience. Top Magn Reson Imaging 2021; 29:181-186. [PMID: 32511199 DOI: 10.1097/rmr.0000000000000247] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
For many patients, numerous unpleasant features of the magnetic resonance imaging (MRI) experience such as scan duration, auditory noise, spatial confinement, and motion restrictions can lead to premature termination or low diagnostic quality of imaging studies. This article discusses practical, patient-oriented considerations that are helpful for radiologists contemplating ways to improve the MRI experience for patients. Patient friendly scanner properties are discussed, with an emphasis on literature findings of effectiveness in mitigating patient claustrophobia, other anxiety, or motion and on reducing scan incompletion rates or need for sedation. As shorter scanning protocols designed to answer specific diagnostic questions may be more practical and tolerable to the patient than a full-length standard-of-care examination, a few select protocol adjustments potentially useful for specific clinical settings are discussed. In addition, adjunctive devices such as audiovisual or other sensory aides that can be useful distractive approaches to reduce patient discomfort are considered. These modifications to the MRI scanning process not only allow for a more pleasant experience for patients, but they may also increase patient compliance and decrease patient movement to allow more efficient acquisition of diagnostic-quality images.
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Affiliation(s)
- Murat Alp Oztek
- Department of Radiology, University of Washington School of Medicine, Seattle, WA.,Department of Radiology, Seattle Children's Hospital, Seattle, WA
| | | | - Michael N Hoff
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - Daniel J Boulter
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Mahmud Mossa-Basha
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - Luke H Beauchamp
- Michigan State University College of Human Medicine, East Lansing, MI
| | - David L Haynor
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - Xuan V Nguyen
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
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Nguyen XV, Oztek MA, Nelakurti DD, Brunnquell CL, Mossa-Basha M, Haynor DR, Prevedello LM. Applying Artificial Intelligence to Mitigate Effects of Patient Motion or Other Complicating Factors on Image Quality. Top Magn Reson Imaging 2020; 29:175-180. [PMID: 32511198 DOI: 10.1097/rmr.0000000000000249] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Artificial intelligence, particularly deep learning, offers several possibilities to improve the quality or speed of image acquisition in magnetic resonance imaging (MRI). In this article, we briefly review basic machine learning concepts and discuss commonly used neural network architectures for image-to-image translation. Recent examples in the literature describing application of machine learning techniques to clinical MR image acquisition or postprocessing are discussed. Machine learning can contribute to better image quality by improving spatial resolution, reducing image noise, and removing undesired motion or other artifacts. As patients occasionally are unable to tolerate lengthy acquisition times or gadolinium agents, machine learning can potentially assist MRI workflow and patient comfort by facilitating faster acquisitions or reducing exogenous contrast dosage. Although artificial intelligence approaches often have limitations, such as problems with generalizability or explainability, there is potential for these techniques to improve diagnostic utility, throughput, and patient experience in clinical MRI practice.
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Affiliation(s)
- Xuan V Nguyen
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Murat Alp Oztek
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
- Seattle Children's Hospital, Seattle, WA
| | - Devi D Nelakurti
- Metro Early College High School, The Ohio State University, Columbus, OH
| | | | - Mahmud Mossa-Basha
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - David R Haynor
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - Luciano M Prevedello
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
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Mayr NA, Yuh WTC, Oztek MA, Nguyen XV. Human Touch for High-Tech Imaging and Imaging-Guided Procedures: Integrative Medicine Strategies for Patient-Centered Nonpharmacologic Approaches: Part 1: Challenges for High-Tech Imaging and Procedures: How Can Integrative Medicine Impact Quality and Operations? Top Magn Reson Imaging 2020; 29:123-124. [PMID: 32568973 DOI: 10.1097/rmr.0000000000000240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Nina A Mayr
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA
| | - William T C Yuh
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - Murat A Oztek
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - Xuan V Nguyen
- Department of Radiology, The Ohio State University College of Medicine, Columbus, OH
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12
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Human Touch for High-Tech Imaging and Imaging-Guided Procedures Integrative Medicine Strategies for Patient-Centered Nonpharmacologic Approaches: Part 2: Overcoming Anxiety in Imaging and Invasive Procedures: What can Physics, Technology, and Integrative Medicine Do for Us? Top Magn Reson Imaging 2020; 29:165-166. [PMID: 32511196 DOI: 10.1097/rmr.0000000000000250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Ajam AA, Tahir S, Makary MS, Longworth S, Lang EV, Krishna NG, Mayr NA, Nguyen XV. Communication and Team Interactions to Improve Patient Experiences, Quality of Care, and Throughput in MRI. Top Magn Reson Imaging 2020; 29:131-134. [PMID: 32568975 DOI: 10.1097/rmr.0000000000000242] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Patients undergoing MRI may experience fear, claustrophobia, or other anxiety manifestations due to the typically lengthy, spatially constrictive, and noisy MRI acquisition process and in some cases are not able to tolerate completion of the study. This article discusses several patient-centered aspects of radiology practice that emphasize interpersonal interactions. Patient education and prescan communication represent 1 way to increase patients' awareness of what to expect during MRI and therefore mitigate anticipatory anxiety. Some patient interaction strategies to promote relaxation or calming effects are also discussed. Staff teamwork and staff training in communication and interpersonal skills are also described, along with literature evidence of effectiveness with respect to patient satisfaction and productivity endpoints. Attention to how radiologists, nurses, technologists, and other members of the radiology team interact with patients before or during the MRI scan could improve patients' motivation and ability to cooperate with the MRI scanning process as well as their subjective perceptions of the quality of their care. The topics discussed in this article are relevant not only to MRI operations but also to other clinical settings in which patient anxiety or motion represent impediments to optimal workflow.
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Affiliation(s)
- Amna A Ajam
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | | | - Mina S Makary
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Sandra Longworth
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | | | - Nidhi G Krishna
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Nina A Mayr
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA
| | - Xuan V Nguyen
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
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Nguyen XV, Tahir S, Bresnahan BW, Andre JB, Lang EV, Mossa-Basha M, Mayr NA, Bourekas EC. Prevalence and Financial Impact of Claustrophobia, Anxiety, Patient Motion, and Other Patient Events in Magnetic Resonance Imaging. Top Magn Reson Imaging 2020; 29:125-130. [PMID: 32568974 DOI: 10.1097/rmr.0000000000000243] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Claustrophobia, other anxiety reactions, excessive motion, and other unanticipated patient events in magnetic resonance imaging (MRI) not only delay or preclude diagnostic-quality imaging but can also negatively affect the patient experience. In addition, by impeding MRI workflow, they may affect the finances of an imaging practice. This review article offers an overview of the various types of patient-related unanticipated events that occur in MRI, along with estimates of their frequency of occurrence as documented in the available literature. In addition, the financial implications of these events are discussed from a microeconomic perspective, primarily from the point of view of a radiology practice or hospital, although associated limitations and other economic viewpoints are also included. Efforts to minimize these unanticipated patient events can potentially improve not only patient satisfaction and comfort but also an imaging practice's operational efficiency and diagnostic capabilities.
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Affiliation(s)
- Xuan V Nguyen
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | | | - Brian W Bresnahan
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - Jalal B Andre
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | | | - Mahmud Mossa-Basha
- Department of Radiology, University of Washington School of Medicine, Seattle, WA
| | - Nina A Mayr
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA
| | - Eric C Bourekas
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
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